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NPI Code Detail

MEDICARE: KYLIE POPPELL PA-C

MEDICARE: KYLIE POPPELL PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1841026283
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLIE POPPELL PA-C
Provider Business Mailing Address
First Line : 620 DR CALVIN JONES HWY STE 212
Second Line :
City : WAKE FOREST
State : NC
Zip : 27587-3108
Country : US
Telephone Number : 919-761-5678
Fax Number :
Provider Business Practice Location Address
First Line : 620 DR CALVIN JONES HWY STE 212
Second Line :
City : WAKE FOREST
State : NC
Zip : 27587-3108
Country : US
Telephone Number : 919-761-5678
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2024
Last Update Date : 02/04/2026

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Directions to “ KYLIE POPPELL PA-C” Practice Location

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